Health and economic consequences of substance abuse. Substance use is a significant public health issue in the U.S. Over 57.8 million Americans aged 12 or older binge drink and 19.9 million individuals aged 12 or older use illicit drugs. Nearly one-fourth of Americans smoke cigarettes, and cigarette smoking remains the leading preventable cause of morbidity and mortality in the U.S(2) Over 22.3 million Americans meet criteria for a SUD Substance use among youth also remains a major public health problem. According to the schoolbased. Monitoring the Future study , almost half (47%) of all 12 graders have tried an illicit drug in their lifetime. Cannabis is the most prevalent illicit psychoactive substance used by adolescents in the U.S.(2) with 43% of 12th graders reporting marijuana use. Additionally, 72% of youth in this age group have used alcohol, and over 55% have been drunk. Approximately 45% of this group has used cigarettes. Further, rates of nonmedical use of prescripfion opioids among youth have markedly increased in the recent past (e.g., 1 in ten 12th graders report non-medical use of Vicodin in the past year)(3). Substance use results in numerous, significant social, medical, psychological, and economic consequences and is associated with marked productivity losses, criminality, and health care costs, including illness and infectious diseases, such as HIV and hepatifis. Approximately one in five deaths in the U.S. (more than one-half million persons each year) is a result of substance use(4). Recent esfimates indicate that the cost of SUDs in the U.S. is over one-half trillion dollars(5).